Module information
Module details
- Title
- Craniofacial and Trauma Rehabilitation
- Type
- Specialist
- Module code
- S-R-S1
- Credits
- 20
- Phase
- 2
- Requirement
- Compulsory
Aim of this module
This module will be an introduction to the clinical aspects of medical device manufacture, planning, craniofacial prosthetic treatment and the management of patients.
Work-based content
Training activities
| # | Learning outcome | Training activity | Type | Action |
|---|---|---|---|---|
| # 1 | Learning outcome 1, 2, 3, 5, 6, 7, 8, 9 |
Training activities
Plan design and manufacture simple custom medical devices to support treatment of dentoalveolar fractures |
Type ETA | Action View |
| # 2 | Learning outcome 1, 2, 3, 5, 6, 7, 8, 9 |
Training activities
Plan, design and manufacture a range of devices to support treatment of mandibular fractures |
Type ETA | Action View |
| # 3 | Learning outcome 1, 2, 3, 5, 6, 8, 9 |
Training activities
Plan, design and manufacture a range of body contour prosthetics to include simple breast or leg contour defects |
Type DTA | Action View |
| # 4 | Learning outcome 1, 2, 3, 5, 6, 7, 8, 9 |
Training activities
Contribute to the design, processing, and manufacture of surgical guides, and pre-bent fixation plates (laboratory) for complex surgical reconstruction in either trauma, oncology or craniofacial cases |
Type ETA | Action View |
| # 5 | Learning outcome 1, 2, 3, 5, 6, 8, 9 |
Training activities
Plan, design and manufacture a device for dynamic keloid splint scar therapy. Adjust and fit the final splint and provide instruction and aftercare support |
Type DTA | Action View |
| # 6 | Learning outcome 1, 2, 3, 5, 7, 8, 9 |
Training activities
Attend a head and neck oncology multidisciplinary team meeting, and communicate a treatment plan discussed at the multidisciplinary team meeting to the Reconstructive/Maxillofacial Prosthetist team |
Type DTA | Action View |
| # 7 | Learning outcome 1, 2, 3, 5, 6, 8, 9 |
Training activities
Plan design and manufacture surgical dressing plates for edentulous and partially dentate patient’s undergoing a hemi-maxillectomy |
Type DTA | Action View |
| # 8 | Learning outcome 1, 2, 3, 4, 5, 6, 8, 9 |
Training activities
Plan, design and manufacture a 1-part hollow box and 2-part soft flexible bung obturator |
Type DTA | Action View |
| # 9 | Learning outcome 1, 3, 4, 5, 6, 7, 8, 9 |
Training activities
Monitor a patient post operatively who has undergone surgical resection and assess the timing of their maxillofacial prosthetic rehabilitation |
Type DTA | Action View |
| # 10 | Learning outcome 1, 2, 3, 4, 5, 6, 8, 9 |
Training activities
Work with specialist Speech and Language Therapists and the Maxillofacial Surgeon in the manufacture of specialist devices to include speech bulbs/palatal lift devices and nasal obturators (hyper nasal speech) Plan, design and manufacture a specialist device |
Type DTA | Action View |
| # 11 | Learning outcome 1, 2, 3, 4, 5, 6, 7, 8, 9 |
Training activities
Plan design and manufacture a custom alloplastic cranioplasty implant Support the surgical team fitting the implant in the operating theatre |
Type DTA | Action View |
| # 12 | Learning outcome 1, 2, 3, 4, 6, 7, 8 |
Training activities
Under supervision record a comprehensive and contemporaneous history for a patient requiring prosthetic rehabilitation |
Type ETA | Action View |
| # 13 | Learning outcome 1, 2, 3, 5, 6, 7, 9 |
Training activities
Perform a clinical examination of a patient with a craniofacial deformity requiring prosthetic rehabilitation |
Type ETA | Action View |
| # 14 | Learning outcome 1, 2, 3, 5, 6, 7, 8, 9 |
Training activities
Develop a treatment plan for a patient with a craniofacial deformity and assist with a facial impression procedure |
Type ETA | Action View |
| # 15 | Learning outcome 1, 2, 3, 4, 5, 6, 7, 8, 9 |
Training activities
Resolve a patient issue with a prosthesis. Plan design and manufacture a new improved definitive prosthesis. Collect patient feedback on the innovations at a follow up clinic and critically evaluate your definitive prosthesis |
Type ETA | Action View |
| # 16 | Learning outcome 1, 2, 3, 4, 6, 8, 9 |
Training activities
Perform colour matching techniques to skin tones using analogue and digital systems |
Type ETA | Action View |
| # 17 | Learning outcome 1, 2, 3, 6, 8, 9 |
Training activities
Assist with the fitting of a range of auricular prostheses (adhesive, and implant-based) for patients with congenital deformity. Discuss prosthesis management and provide instruction to the patient, carers, or relative |
Type ETA | Action View |
| # 18 | Learning outcome 1, 2, 3, 4, 5, 6, 7, 8, 9 |
Training activities
Undertake a surgical plan for auricular craniofacial osseointegrated implants. Discuss the plan with the patient and consultant surgeon as part of consent process for the planned procedure |
Type DTA | Action View |
| # 19 | Learning outcome 3, 5, 7, 8, 9 |
Training activities
Explain two different implant systems used in craniofacial prosthetics. Compare and contrast the two implant systems |
Type DTA | Action View |
| # 20 | Learning outcome 1, 2, 3, 5, 6, 8, 9 |
Training activities
Generate pre-surgical plans for patients requiring single jaw (BSSO Le Fort 1) and bi-maxillary orthognathic surgery and attend the surgical procedure |
Type ETA | Action View |
Assessments
Complete 4 Case-Based Discussions
Complete 4 DOPS or OCEs
Direct Observation of Practical Skills Titles
- Take and cast a facial impression.
- Plan the manufacture of a definitive obturator.
- Plan the manufacture of a cranial implant suitable for implantation.
- Record a comprehensive and contemporaneous patient history.
- Plan the manufacture of an auricular prosthesis retained by adhesives.
Observed Clinical Event Titles
- Present an oncology case for rehabilitation to the Maxillofacial Prosthetic/Reconstructive Science team.
- Present a simple orthognathic plan to the multidisciplinary team.
- Discuss treatment options with a patient.
- Provide a patient with care and use instructions for their prosthesis.
- Assess a patient for a facial prosthesis, present the findings to a senior colleague.
Learning outcomes
| # | Learning outcome |
|---|---|
| 1 | Deliver quality patient centred care with the best interests of patients in all elements of practice. |
| 2 | Practice in accordance with local and national health and safety policies, regulatory requirements and overall service governance. |
| 3 | Communicate effectively with patients, relatives, healthcare professionals and other stakeholders. |
| 4 | Apply the principals of a quality management system to their professional practice. |
| 5 | Practice in partnership with other clinical specialisms as part of a multidisciplinary team and understand their roles and their impact on patient care and pathway. |
| 6 | Perform clinical investigations, formulate treatment plans and manufacture medical devices to a safe clinical standard. |
| 7 | Analyse and interpret patient investigations, multimodal imaging and information. |
| 8 | Select appropriate biomedical materials and components used in the treatment of patients and the manufacture of custom-made medical devices. |
| 9 | Assess and interpret patients’ needs to provide customised treatment dependent on medical, physical, social and psychological requirements. |
Clinical experiences
Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.
Activities
- Attend theatre/clinic for a mandibular fracture to appreciate how devices are applied in surgery and the relevance to the patient outcome.
- Attend theatre to see complex reconstructions and reflect on the transfer of laboratory planning to the surgical operating process.
- Attend the operating theatre to observe the transfer of laboratory guides and pre bent fixation plates.
- Attend the operating theatre to see primary/intermediate device fitted for a hemi- maxillectomy.
- Attend a post-operative oncology dressing clinic.
- Attend the operating theatre to observe a cranial implant being placed.
- Attend surgical procedure for placement of craniofacial implants for a facial prosthesis which has prepared stents for implant placement.
- Attend craniofacial surgery for patients requiring single jaw (BSSO Le Fort 1) and bi-maxillary orthognathic surgery.
- Shadow an “on call” scientist colleague to appreciate the pressures and urgency of the on-call service.
- Observe the preparation and diagnosis of an oncology specimen.
- Attend a post-operative nurse led dressing clinic to appreciate the stages of the healing process.
- Observe wafer trial pre-operatively with the Orthodontist/Surgeon to see the adjustments required.
Academic content (MSc in Clinical Science)
Important information
The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.
Learning outcomes
On successful completion of this module the trainee will be able to:
- Reflect upon the range of patients referred for trauma/congenital deformity, the care support pathways and teams involved from initial consultation, consent for treatment, through to completion of treatment identifying the physical and psychological factors of altered body image.
- Critically evaluate the selection of materials, biomaterials, digital and analogue techniques, clinical performance, and the applications and limitations of materials within the manufacture of medical devices.
- Critically evaluate the possible reasons for failure and breakdown of implants and medical devices, risk management, and legal and ethical requirements.
- Discuss the epidemiology, causes, incidences, classification, treatment and preventative strategies with respect to fractures of the middle third of the facial skeleton.
- Evaluate and describe the process of scar formation its incidence and aetiology, appearance and treatment of keloids.
- Discuss the design principles and constructional techniques of basic obturators used in the peri-operative, intermediate and definitive rehabilitation stages of treatment.
- Describe the assessment, management, treatment options and plans for patients undergoing craniofacial surgery for an orbital cranioplasty and analyse pre-surgical plans with analogue and digital techniques.
- Analyse, evaluate and synthesise clinical information to plan and justify a treatment plan for the manufacture of a range of auricular/orbital/facial reconstruction/prostheses for a patient due to congenital deformities involving both the reconstructive scientist and the multidisciplinary team.
Indicative content
Material Science:
Implant types:
- Metallic implant materials
- Ceramic implant materials
- Polymeric implant materials
- Deep-buried implants
- Failure of implants/materials
- New and emerging materials
- Manufacturing techniques of custom-made alloplastic implants
Material selection:
- Material properties
- Material testing
- Standards
- Material behaviour – in vivo and in vitro
- Sterilisation techniques/Microbial contamination for materials and devices
- Effect of bone density on fixation design and function
- Interface problems, one cement, porous growth, direct bonding, interface and passive fixation
Sterilisation techniques-tissue engineering:
- Principles of tissue engineering, stem cell research and its application to hard and soft tissue reconstruction
- 3D printing of substrate structures for scaffolds
- Hard and soft tissue growth
Care pathways for elective surgery and craniofacial surgery:
- Patient demographics and requirements for craniofacial surgery
- Craniofacial surgery – cranioplasties and orthognathic
Psychology:
- Patient evaluation and referrals
- Management of patients fears and anxieties
- Theories of health-related behaviour and effects of drugs, allergies and lifestyle factors on patient health and rehabilitation
- Common psychosocial disorders associated with congenital facial deformities (abnormal psychology, anxiety, depression and psychoses)
- Basic counselling, support groups (physical and online) and communication skills
Digital and 3D data:
- 3D volumetric and 3D surface data acquisition
- 3D planning, software and types
- Comparative analysis of methods of obtaining 3D data and accuracy
- Identification of principle anatomical structures on x-rays, CT, MRI and surface data scans
- Principles of image guided surgery and its implications in maxillofacial and craniofacial surgery
Maxillofacial trauma and anaplastology:
Trauma:
- Fracture sites of the facial skeleton
- Displacement of fractures
- Principles of treatment
- Laboratory constructed devices
- Management of soft tissue injuries, treatments and devices
- Management and technology for maxillofacial trauma
- Sports injuries and prevention
- Factors affecting trauma outcome
Orthognathic surgery:
- Treatment options and plans for single or bimaxillary orthognathic (jaw) surgery
- Analyse pre-surgical plans using analogue and digitally techniques
- Clinical decisions in the treatment of orthognathic (jaw) and craniofacial surgery
Cranioplasties:
- Types of cranioplasties
- Analogue and digital techniques
- Materials used
- Infection control
Dynamic Splint Therapies:
- Histopathology in relation to pressure splinting
- Cranio/maxillofacial appliances – neck splints, microstomia appliances and hand splints
- Keloid aetiology and treatment
Facial and Body Prosthetics:
- Principles of prostheses design
- Retention methods
- Pre-treatment assessment
- Treatment planning
- Pre-prosthetic surgery
- Colour science, including colour technology, material and colour stability
- Impression techniques and material selection
Dentures and obturation:
- Surgical splint design principles
- Classification of post-surgical defects and effect of defect on prosthodontic design
- Materials and techniques used in obturator construction
- Design features of obturator prostheses (i.e. open box, glove obturators, obturator retention, and soft palate obturation).
- Intermediate/definitive obturator prostheses for partially dentate patients